Displaying publications 21 - 40 of 278 in total

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  1. Rullah K, Mohd Aluwi MF, Yamin BM, Abdul Bahari MN, Wei LS, Ahmad S, et al.
    Bioorg Med Chem Lett, 2014 Aug 15;24(16):3826-34.
    PMID: 25027933 DOI: 10.1016/j.bmcl.2014.06.061
    The discovery of potent inhibitors of prostaglandin E2 (PGE2) synthesis in recent years has been proven to be an important game changer in pharmaceutical industry. It is known that excessive production of PGE2 triggers a vast array of biological signals and physiological events that contributes to inflammatory diseases such as rheumatoid arthritis, atherosclerosis, cancer, and pain. In this Letter, we report the synthesis of a series of minor prenylated chalcones and flavonoids which was found to be significantly active in suppressing the PGE2 production secreted by lipopolysaccharide-induced mouse macrophage cells (RAW 264.7). Among the compounds tested, 14b showed a dose-response inhibition of PGE2 production with an IC50 value of 2.1 μM. The suppression upon PGE2 secretion was not due to cell death since 14b did not reduce the cell viability in close proximity to the PGE2 inhibition concentration. The obtained atomic coordinates for the single-crystal XRD of 14b was then applied in the docking simulation to determine the potential important binding interactions with murine COX-2 and mPGES-1 putative binding sites.
  2. Halim AS, Nor FM, Mat Saad AZ, Mohd Nasir NA, Norsa'adah B, Ujang Z
    J Taibah Univ Med Sci, 2018 Dec;13(6):512-520.
    PMID: 31435371 DOI: 10.1016/j.jtumed.2018.10.004
    Objectives: Chitosan, the N-deacetylated derivative of chitin, has useful biological properties that promote haemostasis, analgesia, wound healing, and scar reduction; chitosan is bacteriostatic, biocompatible, and biodegradable. This study determined the efficacy of chitosan derivative film as a superficial wound dressing.

    Methods: This multicentre randomised controlled trial included 244 patients, of whom 86 were treated with chitosan derivative film and 84 with hydrocolloid. The percentage of epithelisation, as well as patient comfort, clinical signs, and patient convenience in application and removal of the dressings were assessed.

    Results: The primary outcome of this study was the percentage of epithelisation. Except for race (p = 0.04), there were no significant differences between groups in sex, age, antibiotic usage, or initial wound size (p > 0.05). There was no significant difference in the mean epithelisation percentage between groups (p = 0.29). Patients using chitosan derivative film experienced more pain during removal of dressing than those in the hydrocolloid group (p = 0.007). The chitosan derivative film group showed less exudate (p = 0.036) and less odour (p = 0.024) than the control group. Furthermore, there were no significant differences between groups in terms of adherence, ease of removal, wound drainage, erythema, itchiness, pain, and tenderness. No oedema or localised warmth was observed during the study.

    Conclusion: This study concluded that chitosan derivative film is equivalent to hydrocolloid dressing and can be an option in the management of superficial and abrasion wounds.

    Clinical trial No: NMRR-11-948-10565.

  3. Klionsky DJ, Abdel-Aziz AK, Abdelfatah S, Abdellatif M, Abdoli A, Abel S, et al.
    Autophagy, 2021 Jan;17(1):1-382.
    PMID: 33634751 DOI: 10.1080/15548627.2020.1797280
    In 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Thus, it is important to formulate on a regular basis updated guidelines for monitoring autophagy in different organisms. Despite numerous reviews, there continues to be confusion regarding acceptable methods to evaluate autophagy, especially in multicellular eukaryotes. Here, we present a set of guidelines for investigators to select and interpret methods to examine autophagy and related processes, and for reviewers to provide realistic and reasonable critiques of reports that are focused on these processes. These guidelines are not meant to be a dogmatic set of rules, because the appropriateness of any assay largely depends on the question being asked and the system being used. Moreover, no individual assay is perfect for every situation, calling for the use of multiple techniques to properly monitor autophagy in each experimental setting. Finally, several core components of the autophagy machinery have been implicated in distinct autophagic processes (canonical and noncanonical autophagy), implying that genetic approaches to block autophagy should rely on targeting two or more autophagy-related genes that ideally participate in distinct steps of the pathway. Along similar lines, because multiple proteins involved in autophagy also regulate other cellular pathways including apoptosis, not all of them can be used as a specific marker for bona fide autophagic responses. Here, we critically discuss current methods of assessing autophagy and the information they can, or cannot, provide. Our ultimate goal is to encourage intellectual and technical innovation in the field.
  4. Ahmad SM, Aznal SS, Tham SW
    Malays Fam Physician, 2015;10(2):2-8.
    PMID: 27099656 MyJurnal
    The objective of this paper was to determine the prevalence of overactive bladder syndrome (OABS) and its risk factors among patients with other gynaecological problems.
  5. Yoon SY, Wong SW, Lim J, Ahmad S, Mariapun S, Padmanabhan H, et al.
    J Med Genet, 2022 Mar;59(3):220-229.
    PMID: 33526602 DOI: 10.1136/jmedgenet-2020-107416
    BACKGROUND: Identifying patients with BRCA mutations is clinically important to inform on the potential response to treatment and for risk management of patients and their relatives. However, traditional referral routes may not meet clinical needs, and therefore, mainstreaming cancer genetics has been shown to be effective in some high-income and high health-literacy settings. To date, no study has reported on the feasibility of mainstreaming in low-income and middle-income settings, where the service considerations and health literacy could detrimentally affect the feasibility of mainstreaming.

    METHODS: The Mainstreaming Genetic Counselling for Ovarian Cancer Patients (MaGiC) study is a prospective, two-arm observational study comparing oncologist-led and genetics-led counselling. This study included 790 multiethnic patients with ovarian cancer from 23 sites in Malaysia. We compared the impact of different method of delivery of genetic counselling on the uptake of genetic testing and assessed the feasibility, knowledge and satisfaction of patients with ovarian cancer.

    RESULTS: Oncologists were satisfied with the mainstreaming experience, with 95% indicating a desire to incorporate testing into their clinical practice. The uptake of genetic testing was similar in the mainstreaming and genetics arm (80% and 79%, respectively). Patient satisfaction was high, whereas decision conflict and psychological impact were low in both arms of the study. Notably, decisional conflict, although lower than threshold, was higher for the mainstreaming group compared with the genetics arm. Overall, 13.5% of patients had a pathogenic variant in BRCA1 or BRCA2, and there was no difference between psychosocial measures for carriers in both arms.

    CONCLUSION: The MaGiC study demonstrates that mainstreaming cancer genetics is feasible in low-resource and middle-resource Asian setting and increased coverage for genetic testing.

  6. M Yusoff NNF, Ahmad S, Wan Abdul Rahman WF, Mohamud R, C Boer J, Plebanski M, et al.
    Cytokine, 2024 Jun;178:156557.
    PMID: 38452440 DOI: 10.1016/j.cyto.2024.156557
    Chronic rhinosinusitis with nasal polyps (CRSwNP) is a subtype of chronic rhinosinusitis (CRS) characterized by the presence of nasal polyps (NP) in the paranasal mucosa. Despite the complex etiology, NP is believed to result from chronic inflammation. The long-term aftermath of the type 2 response is responsible for symptoms seen in NP patients, i.e. rhinorrhea, hyposmia, and nasal obstruction. Immune cellular tolerogenic mechanisms, particularly CD4 + Foxp3 + regulatory T cells (Tregs), are crucial to curtail inflammatory responses. Current evidence suggests impaired Treg activity is the main reason underlying the compromise of self-tolerance, contributing to the onset of CRSwNP. There is compelling evidence that tumor necrosis factor 2 (TNFR2) is preferentially expressed by Tregs, and TNFR2 is able to identify the most potent suppressive subset of Tregs. Tumor necrosis factor (TNF)-TNFR2 interaction plays a decisive role in the activation and expansion of Tregs. This review summarizes current understanding of Tregs biology, focusing on the discussion of the recent advances in the study of TNF-TNFR2 axis in the upregulation of Treg function as a negative feedback mechanism in the control of chronic inflammation. The role of dysregulation of Tregs in the immunopathogenesis of CRSwNP will be analyzed. The future perspective on the harnessing Tregs-mediated self-tolerant mechanism in the management of CRSwNP will be introduced.
  7. Irshad MA, Nawaz R, Rehman MZU, Adrees M, Rizwan M, Ali S, et al.
    Ecotoxicol Environ Saf, 2021 Apr 01;212:111978.
    PMID: 33561774 DOI: 10.1016/j.ecoenv.2021.111978
    Nanotechnology is capturing great interest worldwide due to their stirring applications in various fields. Among nanoparticles (NPs), titanium dioxide (TiO2) NPs have been widely used in daily life and can be synthesized through various physical, chemical, and green methods. Green synthesis is a non-toxic, cost-effective, and eco-friendly route for the synthesis of NPs. Plenty of work has been reported on the green, chemical, physical and biological synthesis of TiO2 NPs and these NPs can be characterized through high tech. instruments. In the present review, dense data have been presented on the comparative synthesis of TiO2 NPs with different characteristics and their wide range of applications. Among the TiO2 NPs synthesis techniques, the green methods have been proven to be efficient than chemical synthesis methods because of the less use of precursors, time-effectiveness, and energy-efficiency during the green synthesis procedures. Moreover, this review describes the types of plants (shrubs, herbs and trees), microorganisms (bacteria, fungi and algae), biological derivatives (proteins, peptides, and starches) employed for the synthesis of TiO2 NPs. The TiO2 NPs can be effectively used for the treatment of polluted water and positively affected the plant physiology especially under abiotic stresses but the response varied with types, size, shapes, doses, duration of exposure, metal species along with other factors. This review also highlights the regulating features and future standpoints for the measurable enrichment in TiO2 NPs product and perspectives of TiO2 NPs reliable application.
  8. Sha'fie MSA, Rathakrishnan S, Hazanol IN, Dali MHI, Khayat ME, Ahmad S, et al.
    Antioxidants (Basel), 2020 Dec 09;9(12).
    PMID: 33317056 DOI: 10.3390/antiox9121253
    Microglial cells are the primary immune cell resident in the brain. Growing evidence indicates that microglial cells play a prominent role in alcohol-induced brain pathologies. However, alcohol-induced effects on microglial cells and the underlying mechanisms are not fully understood, and evidence exists to support generation of oxidative stress due to NADPH oxidases (NOX_-mediated production of reactive oxygen species (ROS). Here, we investigated the role of the oxidative stress-sensitive Ca2+-permeable transient receptor potential melastatin-related 2 (TRPM2) channel in ethanol (EtOH)-induced microglial cell death using BV2 microglial cells. Like H2O2, exposure to EtOH induced concentration-dependent cell death, assessed using a propidium iodide assay. H2O2/EtOH-induced cell death was inhibited by treatment with TRPM2 channel inhibitors and also treatment with poly(ADP-ribose) polymerase (PARP) inhibitors, demonstrating the critical role of PARP and the TRPM2 channel in EtOH-induced cell death. Exposure to EtOH, as expected, led to an increase in ROS production, shown using imaging of 2',7'-dichlorofluorescein fluorescence. Consistently, EtOH-induced microglial cell death was suppressed by inhibition of NADPH oxidase (NOX) as well as inhibition of protein kinase C. Taken together, our results suggest that exposure to high doses of ethanol can induce microglial cell death via the NOX/ROS/PARP/TRPM2 signaling pathway, providing novel and potentially important insights into alcohol-induced brain pathologies.
  9. Shukor MY, Ahmad SA, Nadzir MM, Abdullah MP, Shamaan NA, Syed MA
    J Appl Microbiol, 2010 Jun;108(6):2050-8.
    PMID: 19968732 DOI: 10.1111/j.1365-2672.2009.04604.x
    To isolate and characterize a potent molybdenum-reducing bacterium.
  10. Ahmad SA, Shukor MY, Shamaan NA, Mac Cormack WP, Syed MA
    Biomed Res Int, 2013;2013:871941.
    PMID: 24381945 DOI: 10.1155/2013/871941
    A molybdenum-reducing bacterium from Antarctica has been isolated. The bacterium converts sodium molybdate or Mo⁶⁺ to molybdenum blue (Mo-blue). Electron donors such as glucose, sucrose, fructose, and lactose supported molybdate reduction. Ammonium sulphate was the best nitrogen source for molybdate reduction. Optimal conditions for molybdate reduction were between 30 and 50 mM molybdate, between 15 and 20°C, and initial pH between 6.5 and 7.5. The Mo-blue produced had a unique absorption spectrum with a peak maximum at 865 nm and a shoulder at 710 nm. Respiratory inhibitors such as antimycin A, sodium azide, potassium cyanide, and rotenone failed to inhibit the reducing activity. The Mo-reducing enzyme was partially purified using ion exchange and gel filtration chromatography. The partially purified enzyme showed optimal pH and temperature for activity at 6.0 and 20°C, respectively. Metal ions such as cadmium, chromium, copper, silver, lead, and mercury caused more than 95% inhibition of the molybdenum-reducing activity at 0.1 mM. The isolate was tentatively identified as Pseudomonas sp. strain DRY1 based on partial 16s rDNA molecular phylogenetic assessment and the Biolog microbial identification system. The characteristics of this strain would make it very useful in bioremediation works in the polar and temperate countries.
  11. Sabullah, M. K., Gansau, A. J., Ahmad, S. A., Shamaan, N. A., Khalid, A., Sulaiman, M. R.
    MyJurnal
    The environmental toxicants such as copper are known to affect vital organ especially liver.
    This study examined the effects of copper sulfate (CuSO4) on the liver morphological structure
    of P. javanicus. The untreated control, 0.1 and 0.3 mg/L CuSO4 treated groups displayed normal
    polygonal structure of the hepatocyte. However, at the concentrations of 0.5, 1.0 and 5.0 mg/L
    CuSO4, the hepatostructure was significantly affected, as shown by the increasing number of
    dilation and congestion of sinusoids, vacuolation, macrophage activities and peliosis. The
    damage level and HSI value were increased while the number of hepatic nuclei per mm2 was
    decreased with the increasing of copper concentration. In conclusion, this study shows that the
    degree of liver damage in P.javanicus is dependent to the dose exposure.
  12. Kuan, C.H., Rukayadi, Y., Ahmad, S. H., Wan Mohamed Radzi, C.W.J., Kuan, C.S., Yeo, S.K., et al.
    MyJurnal
    Listeriosis and salmonellosis are the major foodborne illnesses worldwide. Over the last decade,
    increasing reports about the antibiotic resistance of Listeria monocytogenes and Salmonella from diverse sources have prompted public health concerns, especially in developing countries with over reliance or misuse of antibiotic drugs in the treatment of humans and animals. In this study, antibiotic susceptibility profiles of 58 L. monocytogenes and 12 Salmonella Enteritidis strains from vegetable farms and retail markets in Malaysia were testedby the standard disk diffusion method. Listeria monocytogenes isolates were found to exhibit 100% resistance to penicillin G. Also, high resistance patterns were observed for meropenem (70.7%) and rifampicin (41.4%). The multiple antibiotic resistance (MAR) index of L. monocytogenes isolates ranged from 0.11 to 0.56. Besides, the antibiogram results revealed that multidrugresistant (MDR) S. Enteritidis were detected and all the S. Enteritidis isolates demonstrated resistance to at least four antibiotics. Ampicillin, amoxicillin, and trimethoprim failed to inhibit all the S. Enteritidis strains. Salmonella Enteritidis isolates also displayed high resistance to nalidixic acid (75.0%), trimethoprim-sulfamethoxazole (75.0%), and chloramphenicol (66.7%). Findings in this study indicated that vegetables could be potential sources of multidrug resistance of L. monocytogenes and S. Enteritidis, which can be a serious issue and a major concern for public health. Thus, there is a great need for surveillance programs in Malaysia to continuously monitor the antibiotic resistance profiles of important pathogens.
  13. Ahmad S, Israf DA, Lajis NH, Shaari K, Mohamed H, Wahab AA, et al.
    Eur J Pharmacol, 2006 May 24;538(1-3):188-94.
    PMID: 16650843
    Some chalcones, such as hydroxychalcones have been reported previously to inhibit major pro-inflammatory mediators such as nitric oxide (NO), prostaglandin E(2) (PGE(2)), tumor necrosis factor-alpha (TNF-alpha) and reactive oxygen species production by suppressing inducible enzyme expression via inhibition of the mitogen-activated protein kinase (MAPK) pathway and nuclear translocation of critical transcription factors. In this report, the effects of cardamonin (2',4'-dihydroxy-6'-methoxychalcone), a chalcone that we have previously isolated from Alpinia rafflesiana, was evaluated upon two cellular systems that are repeatedly used in the analysis of anti-inflammatory bioactive compounds namely RAW 264.7 cells and whole blood. Cardamonin inhibited NO and PGE(2) production from lipopolysaccharide- and interferon-gamma-induced RAW cells and whole blood with IC(50) values of 11.4 microM and 26.8 microM, respectively. Analysis of thromboxane B(2) (TxB(2)) secretion from whole blood either stimulated via the COX-1 or COX-2 pathway revealed that cardamonin inhibits the generation of TxB(2) via both pathways with IC(50) values of 2.9 and 1.1 microM, respectively. Analysis of IC(50) ratios determined that cardamonin was more COX-2 selective in its inhibition of TxB(2) with a ratio of 0.39. Cardamonin also inhibited the generation of intracellular reactive oxygen species and secretion of TNF-alpha from RAW 264.7 cells in a dose responsive manner with IC(50) values of 12.8 microM and 4.6 microM, respectively. However, cardamonin was a moderate inhibitor of lipoxygenase activity when tested in an enzymatic assay system, in which not a single concentration tested was able to cause an inhibition of more than 50%. Our results suggest that cardamonin acts upon major pro-inflammatory mediators in a similar fashion as described by previous work on other closely related synthetic hydroxychalcones and strengthens the conclusion of the importance of the methoxyl moiety substitution on the 4' or 6' locations of the A benzene ring.
  14. Isa MH, Asaari FA, Ramli NA, Ahmad S, Siew TS
    Waste Manag Res, 2005 Dec;23(6):565-70.
    PMID: 16379126
    The implementation of a suitable solid waste management programme with appropriate methods of recycling as an inherent element is vital to the alleviation of the problems associated with solid waste generation, handling and disposal, environmental conservation, public hygiene, etc. The present work is a case study on solid waste collection and recycling practices in Nibong Tebal town, Penang, Malaysia. The amount and types of domestic waste generated, household participation in recycling, identification of existing problems related to the implementation of the recycling programme, etc. formed the basis of this study. Surveys (interviews/questionnaires) and on-site observations were conducted to gather information on the solid waste collection and recycling practice of the residents. A focus group of 60 individuals was selected and their response to a questionnaire, prepared according to a Likert scale, was obtained and analysed. The majority of the respondents expressed concerns about recycling and wanted more to be done in this regard. Illegal collection, aesthetically displeasing sites and a lack of public awareness were problems of major concern. Issues related to inadequate funding and manpower as well as end market are also addressed and suggestions made.
  15. Sabullah, M. K., Khalidi, S. A. M., Abdullah, R., Sani, S. A., Gansau, J. A., Ahmad, S. A., et al.
    MyJurnal
    Heavy metals with high chemical activity from sludge and waste release, agriculture, and
    mining activity are a major concern. They should be carefully managed before reaching the
    main water bodies. Excessive exposure to heavy metal may cause toxic effect to any types of
    organism from the biomolecular to the physiological level, and ultimately cause death. Monitoring is the best technique to ensure the safety of our environment before a rehabilitation is
    needed. Nowadays, enzyme-based biosensors are utilised in biomonitoring programmes as
    this technique allows for a real-time detection and rapid result. It is also inexpensive and easy
    to handle. Enzyme-based biosensors are an alternative for the preliminary screening of
    contamination before a secondary screening is performed using high-performance technology.
    This review highlights the current knowledge on enzyme-based biosensors, focusing on
    cholinesterase for toxic metal detection in the environment.
  16. Hendra R, Ahmad S, Oskoueian E, Sukari A, Shukor MY
    PMID: 22070850 DOI: 10.1186/1472-6882-11-110
    Phaleria macrocarpa (Scheff.) Boerl (Thymelaceae) originates from Papua Island, Indonesia and grows in tropical areas. The different parts of the fruit of P. macrocarpa were evaluated for antioxidant, anti-inflammatory, and cytotoxic activities.
  17. Arif NM, Ahmad SA, Syed MA, Shukor MY
    J Basic Microbiol, 2013 Jan;53(1):9-19.
    PMID: 22581645 DOI: 10.1002/jobm.201100120
    In this work, we report on the isolation of a phenol-degrading Rhodococcus sp. with a high tolerance towards phenol. The isolate was identified as Rhodococcus sp. strain AQ5NOL 2, based on 16S rDNA analysis. The strain degraded phenol using the meta pathway, a trait shared by many phenol-degraders. In addition to phenol biodegradation, the strain was also capable of degrading diesel. Strain AQ5NOL 2 exhibited a broad optimum temperature for growth on phenol at between 20 °C and 35 °C. The best nitrogen sources were ammonium sulphate, glycine or phenylalanine, followed by proline, nitrate, leucine, and alanine (in decreasing efficiency). Strain AQ5NOL 2 showed a high tolerance and degradation capacity of phenol, for it was able to register growth in the presence of 2000 mg l(-1) phenol. The growth of this strain on phenol as sole carbon and energy source were modeled using Haldane kinetics with a maximal specific growth rate (μ(max)) of 0.1102 hr(-1), a half-saturation constant (K(s) ) of 99.03 mg l(-1) or 1.05 mmol l(-1), and a substrate inhibition constant (K(i)) of 354 mg l(-1) or 3.76 mmol l(-1). Aside from phenol, the strain could utilize diesel, 2,4-dinitrophenol and ρ-cresol as carbon sources for growth. Strain AQ5NOL 2 exhibited inhibition of phenol degradation by Zn(2+), Cu(2+), Cr(6+), Ag(+) and Hg(2+) at 1 mg l(-1).
  18. Othman AR, Bakar NA, Halmi MI, Johari WL, Ahmad SA, Jirangon H, et al.
    Biomed Res Int, 2013;2013:371058.
    PMID: 24369531 DOI: 10.1155/2013/371058
    Molybdenum is very toxic to agricultural animals. Mo-reducing bacterium can be used to immobilize soluble molybdenum to insoluble forms, reducing its toxicity in the process. In this work the isolation of a novel molybdate-reducing Gram positive bacterium tentatively identified as Bacillus sp. strain A.rzi from a metal-contaminated soil is reported. The cellular reduction of molybdate to molybdenum blue occurred optimally at 4 mM phosphate, using 1% (w/v) glucose, 50 mM molybdate, between 28 and 30 °C and at pH 7.3. The spectrum of the Mo-blue product showed a maximum peak at 865 nm and a shoulder at 700 nm. Inhibitors of bacterial electron transport system (ETS) such as rotenone, sodium azide, antimycin A, and potassium cyanide could not inhibit the molybdenum-reducing activity. At 0.1 mM, mercury, copper, cadmium, arsenic, lead, chromium, cobalt, and zinc showed strong inhibition on molybdate reduction by crude enzyme. The best model that fitted the experimental data well was Luong followed by Haldane and Monod. The calculated value for Luong's constants p max, K(s), S(m), and n was 5.88 μmole Mo-blue hr(-1), 70.36 mM, 108.22 mM, and 0.74, respectively. The characteristics of this bacterium make it an ideal tool for bioremediation of molybdenum pollution.
  19. Shah SA, Safian N, Ahmad S, Wan Ibadullah WAH, Mohammad ZB, Nurumal SR, et al.
    PMID: 33917528 DOI: 10.3390/ijerph18073831
    Happiness is an essential component to experience healthy ageing. Hence, understanding the factors that contribute to happiness is important. This study aimed to determine the factors associated with happiness among the elderly population in Malaysia. In this study, 1204 respondents were recruited from urban and rural areas in Selangor. A face-to-face interview was conducted using the Bahasa Malaysia version of the Japan Gerontological Evaluation Study questionnaire. The inclusion criteria include Malaysians who are 60-years old and above and can converse in the Malaysian language. Those who encounter less than seven scores for the Abbreviated Mental Test were excluded from the study. Among the 1204 respondents, 953 (79.2%) were happy. Sociodemographic characteristics showed that being a men, age of 60 to 74 years, and living in urban areas were significantly associated with happiness. A logistic regression model showed that locality (aOR 1.61), income category (Bottom 40% aOR 0.49; Middle-class group 40% aOR 1.40), social engagement (active aOR 1.77; less active aOR 1.25), receiving emotional support (aOR 2.11) and handgrip strength (aOR 1.02) were significantly associated with happiness. Thus, ensuring the elderly population in receiving emotional support and active social engagement among them can enhance their happiness level.
  20. Shah SA, Rosenberg M, Ahmad D, Ahmad S, Safian N, Shobugawa Y
    Health Res Policy Syst, 2022 Nov 29;20(Suppl 1):127.
    PMID: 36443790 DOI: 10.1186/s12961-022-00915-1
    BACKGROUND: Hypertension is a major cause of morbidity and mortality worldwide. Although multiple studies have assessed the prevalence of hypertension among older people, no study has examined the unmet need for hypertension care among older people in Malaysia. This study uses the hypertension care cascade to identify the prevalence of unmet needs for hypertension care and their determinants among the older population in Selangor.

    METHODS: This is a cross-sectional study involving a total of 1204 participants recruited from different areas in Selangor. A face-to-face interview was conducted using the Bahasa Malaysia version of the Japan Gerontological Evaluation Study questionnaire. The inclusion criteria were Malaysians aged ≥ 60 years who could converse in Bahasa Malaysia.

    RESULTS: Among the 637 participants with hypertension, 18% (117) had not been previously screened but were found to have BP ≥ 140/90 mmHg, 21% (136) were undiagnosed, 3% (17) were untreated, 42% (267) were treated with antihypertensive medication but still had high blood pressure, and 16% (100) had hypertension that was controlled with medication. The hypertension care cascade demonstrates that 18% (117) of those with hypertension had never been screened for hypertension; 26% (136/520) of those who were screened never received a diagnosis; 4% (17/384) of those who were diagnosed did not receive treatment; and 73% (267/367) of those who were treated did not reach the threshold for control. The prevalence of total unmet needs was 84% (537/637). Statistically significant determinants of having any unmet need for hypertension care were smoking status and medical history, with adjusted odds ratios and 95% confidence intervals (CIs) in the multivariate analysis of 0.5 (95% CI: 0.3-0.9) for being a smoker, 2.8 (95% CI: 1.1-6.9) for having a history of stroke and 1.6 (95% CI: 1.0-2.5) for having a history of diabetes mellitus.

    CONCLUSIONS: The prevalence of unmet need for hypertension care among the older population in Selangor is 84% (537/637), which is alarmingly high. This study highlights where and how much of the loss of care for hypertension happens in the care cascade and provides insight into the efforts required to improve effective service coverage to manage the increasing burden of hypertension associated with population ageing.

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